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Objective To investigate the diagnosis and treatment of primary hyperparathyroidism ( PHPT) initially with urinary calculus .Methods The clinical data of 26 patients who diagnosed as PHPT ini-tially with urinary calculus were retrospectively reviewed .Results There were 22 cases with bilateral urinary calculus and 4 cases with unilateral relapsed urinary calculus .Ultrasonography , CT and radionuclide were helpful to determine the location of the neoplasia .24 cases underwent percutaneous nephroscope or ureteroscopy pneu-matic ballistic lithotripsy , 2 cases discharged ureteral calculi by themselves .All patients were performed surgical treatment of PHPT , which was confirmed by intraoperative frozen pathology and postoperative pathological exami -nation.There was great improvement of clinical symptoms after surgical procedures .The preoperative serum calci-um, urine calcium and parathyroid hormone elevated , while serum phosphate decreased .The postoperative indi-cators were just the opposite .The difference had statistical significance ( P<0.05 ) .Conclusions Laboratory investigations and imaging studies are very important to diagnose PHPT initially with urinary calculus .The para-thyroid surgery can remarkably reduce the calculus recurrence and improve renal function .
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<p><b>OBJECTIVE</b>To explore the feasibility and safety of scarless laparoscopic radical resection of rectal cancer.</p><p><b>METHODS</b>Clinical data of 26 patients who underwent scarless laparoscopic radical resection of rectal cancer from January 2011 to June 2013 were retrospectively analyzed. Lymph node dissection and transection of proximal and distal colon were performed in the conventional manner of total mesorectal excision (TME). The distal rectum 2 cm away from the tumor was closed with a linear stapler, and was pulled out through the anus. The specimen was extracted through the Alexis. The rectal opening was reclosed with a linear stapler. End-to-end colorectal anastomosis was performed using the double-stapling technique.</p><p><b>RESULTS</b>The operation time was (126±35) min. The intraoperative blood loss was (33±61) ml. The number of harvested lymph nodes was 17.0±5.6. The time to first bowel movement was (2.7±1.3) d. The postoperative hospital stay was (7.9±2.6) d. Only one case developed anastomotic hemorrhage.</p><p><b>CONCLUSION</b>Scarless laparoscopic radical resection of rectal cancer is feasible.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Anastomosis Quirúrgica , Métodos , Laparoscopía , Métodos , Escisión del Ganglio Linfático , Neoplasias del Recto , Cirugía General , Estudios RetrospectivosRESUMEN
Objective To study the influence of vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) on invasion and metastasis of human colorectal carcinoma. Methods VEGF expression was detected by SABC immunohistochemical method and the new growth microvessels were highlighted by SP immunohistochemical staining of CD34 endothelial antigen in 61 colorected carcinoma tissues, and the MVD of tumor tissues was calculated. Results The positive expression rate of VEGF was 49 2% and the average MVD was 28 7?12 9 in colorectal carcinoma tissues. The VEGF expression and MVD in colorectal carcinoma tissues were significantly associated with the depth of invasion, lymph node metastasis, liver metastasis and Dukes' stage (P
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Objective To investigate the effect of binding pancreaticojejunostomy (BPJ) on the prevention of the pancreatic leakage after pancreaticoduodenectomy(PD). Methods The clinical data of 108 patients who underwent PD, including 26 cases of BPJ since 2001 and 82 cases of other type of pancreaticojejunostomy from 1993 to 2000,were retrospectively analyzed. Results The frequency of pancreatic leakage in this series was 13.9%. No pancreatic leakage occurred in BPJ group, whereas the frequency of pancreatic leakage in end-to-end invaginated pancreaticojejunostomy group and duct-to-mucosa pancreaticojejunostomy group was 24.6%(14/57) and 4.0%(1/25),respectively. The frequency of pancreatic leakage in BPJ group was significantly lower than that in end-to-end invaginated pancreaticojejunostomy group(P0.05). Conclusion BPJ may be effective in the prevention of the pancreatic leakage after PD.
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Objective: To study the influence of vascular endothelial growth factor(VEGF) expression on angiogenesis,the relationship of VEGF expression and microvessel density (MVD) with invasion and metastasis of colorectal carcinoma.Methods: Sixty-one samples of colorectal carcinoma tissues were examined for VEGF expression by SABC immunohistochemical method and for the CD34 endothelial antigen by SP immunohistochemical method to highlight the new growth microvessels,the MVD of tumor was calculated.Results: The positive expression rate of VEGF was 49.2% and the mean of MVD was 28.7?12.9 (range from 6 to 55) in colorectal carcinoma tissues.The positive expression rate of VEGF and MVD were significantly correlated with the depth of invasion,lymph node metastasis,liver metastasis and Dukes’s stage(P29) was significantly higher than that in group of lower MVD.MVD in group of VEGF positive expression was significantly higher than that in negative expression group (P
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ObjectiveTo investigate the effect of TPN and Ulinastatin(UTI) on acute phase proteins (APP) metabolism in postoperative patients with advanced gastrointestinal carcinoma.MethodsSixty postoperative patients were randomly divided into four groups: control group( n =15) receiving routine iv infusion; UTI group( n = 15) receiving iv infusion and UTI; TPN group( n =15) and UTI+TPN group( n =15). The serum acute phase proteins and nitrogen balance were observed. ResultsThe decrease of serum APP was greater in control group and TPN group than in UTI group and UTI+TPN group( P
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Objective To investigate the value of laparoscopy combined with choledochoscopy in treatment of cholecystolithiasis complicated with choledocholithiasis.Methods Clinical data of 168 patients with cholecystolithiasis and choledocholithiasis treated in our haspital from June 2005 to June 2009 were analysed.Ninety patients were randomly selected and treated by laparoscopic cholecystectomy combined with choledocholithotomy and T-tube drainage (group A),the other 78 patients,as control group,underwent routine cholecystectomy and choledocholithotomy plus T-tube drainage by laparotomy (group B).Results The hospital stay and the mean time to passage of flatus in group A was much shorter than that in group B (P0.05).Conclusions Laparoscopic cholecystectomy combined with choledocholithotomy and T-tube drainage for cholecystolithiasis and choledocholithiasis is a microtrauma management with advantages of quick recovery and shorter hospital stay,that makes it superior to the open operation.